Methods
We identified all patients who underwent a tonsillectomy (+/- other
concurrent ENT procedures) by the main author at our local hospital.
Informed consent was obtained from each participant prior to their
procedure. The SQUIRE framework was used as our reporting guideline.
A two-cycle design was used for data collection, which involved the
following: (1) a pre-intervention retrospective cycle covering two years
and (2) a post-intervention prospective cycle covering the subsequent
five-years. For each patient included in the study, the following
parameters were noted:
- Type of procedure performed,
- Indication for surgery,
- Post-operative complications including,
- Primary haemorrhage,
- Secondary haemorrhage,
- Post operative infection.
We studied the management of all complications, particularly
highlighting those who required further surgical intervention. Following
this, we calculated the bleeding rate per annum for primary and
secondary bleeds, with the intention to compare this to our subsequent
data collection following implementation of our proposed change in
practice for achieving and checking haemostasis.
The inclusion criteria included all dissection tonsillectomy procedures
in children and adults by the main author. The exclusions included
patients who had a tonsillectomy for histology due to suspected
tonsillar cancer, and patients had a coblation intracapsular
tonsillotomy. Patients with suspected tonsillar cancer have a
potentially challenging vascular surgical field that might affect the
haemorrhagic tendency and therefore skew the results. Similarly,
intracapsular coblation tonsillotomy is a different procedure to
dissection tonsillectomy and cannot be included into the sample.